| NPI | 1639662935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KY PT-008517) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WA 60837912) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-07-19 |